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Application Form for Merchandise Exports from India Scheme (MEIS)

DGFT - ANF -3A - 1[ANF -3A (Kindly read Paras 3.03 to 3.06 of FTP and Para 3.01 to 3.03 of HBP and other common procedural features applicable to MEIS before filing application) Please note that separate applications are required to be filed for separate years (AM15, AM16 etc.) based on Let Export date. Shipments from EDI Ports and Non-EDI Ports cannot be clubbed in one application. Shipments from different EDI Ports can be clubbed together in a single application for a given licensing year. Sep .....

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e application 3. Details of Export : Shipping Bill Details and Other details Sl.No. Shipping Bill/Airway Bill Number Date of Shipping Bill/Airway Bill Port Code Let export date ITC (HS) code Product Description as per Sipping Bill Country Name and Relevant Sl No. of Appendix 3B( Part 1) Product Sl No. of Appendix 3B (Part 2) Realized FOB value of Exports or FOB value as given in S/B, whichever is less (in free foreign exchange) Date of realization Date of realization Value Currency Code (1) (2) .....

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s have taken place in case of EDI Shipments. In case of Non EDI Shipments, the port of shipment shall be the port from which exports have taken place) 6. DECLARATION / UNDERTAKING 1 I/We hereby certify that : A. the entity for whom the application has been made have not been penalized under any of the following Acts (as amended from time to time): (i) The Customs Act, 1962, (ii) The Central Excise Act 1944, (iii) Foreign Trade (Development & Regulation) Act 1992, (iv) The Foreign Exchange Ma .....

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Division(s) has been declared a defaulter and has otherwise been made ineligible for undertaking import / export under any of the provisions of the Policy; 2 I/We undertake to abide by the provisions of the Foreign Trade (Development and Regulation) Act, 1992, as amended from time to time, the Rules and Orders framed there under, the Foreign Trade Policy, the Handbook of Procedures 3. I/We hereby certify that that particulars and statements made in this application are true and correct and nothi .....

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urrently included in this application. 6 I hereby declare that in terms of Para 3.17 of FTP, this application does not contain any exports in contravention to this provision. I further declare that these goods have actually been exported out of India 7 I hereby declare that the Exported Product/goods and markets are covered under Appendix 3B and the exports, for which this application is being filed, are made on or after the respective admissible date of export, as indicated in relevant Appendix .....

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uch documentary evidence, I undertake to refund the amount of scrip in cash with interest at the rate prescribed under section 28AA of Customs Act, 1962, from the date of such scrip as prescribed in FTP and HBP and shall also be liable for penal action as per FTDR act. Tick the box as acceptance of declaration/ undertaking and fill in the details below. Signature of the Applicant Name Designation Official Address Flat/Plot/Block No Street/Area/Locality City State PIN Code Telephone No. Country C .....

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not be clubbed in one application. Application shall be filed for each EDI port and each Non EDI port separately. Part A 1. Applicant Details: i IEC No. ii Name iii Address iv Telephone No v Email ID Part B 2. Application Details: (i) Export Licensing Year (pl. specify the year in which export has been made, based on Let export date (Para 9.12 of HBP): (ii) Date of filing of Application: (iii) Port of Export for this Application: Note: Applicant to select/feed the details of one shipping bill at .....

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(4) (5) (6) (7) (8) (9) (10) (11) (12) Exchange Rate FOB in Rs.ie 10x13 Rate of Entitlement as per Appendix 3B (Part 2) (%) Entitlement Amount (in Rs.) Late Cut % if any Late cut Amount(in Rs.) Entitlement after Late Cut (in Rs.) (13) (14) (15) (16) (17) 18 19 (16) = (14) X(15) 18=(16X17 19=16-18 4. Number of Split Certificates required (in multiples of ₹ 5 lakhs each): 5. Port of Registration for the purpose of imports.(The port of registration shall be the port from which exports have t .....

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rtners / Proprietor / Karta / Trustees of the company /firm /HUF/Trust, (as the case may be), is/are a Director(s) / Partner(s) / Proprietor / Karta / Trustee in any other Company/ firm / entity which is on the Denied Entity List (DEL) of DGFT; C. neither the Registered Office of the company / Head Office of the firm / nor any of its Branch Office(s)/ Unit(s)/ Division(s) has been declared a defaulter and has otherwise been made ineligible for undertaking import / export under any of the provisi .....

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